宫颈糜烂、巴氏染色与液基细胞(LCT)对宫颈癌筛查的研究  

Study on Cerival Erosin, Pap smears and Liguid-based cytologic test(LCT) for cervical carcin screening

作　　者：袁锦玉 卢义生[2] 刘军[2] 罗淑贞[2] 付莉萍[2] 郭健[2] 

机构地区：[1]广东省东莞卫生学校 [2]东莞市人民医院,广东东莞523018

出　　处：《赣南医学院学报》2005年第1期91-93,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:评价AutoCyteprep液基细胞学(LCT)薄片制片,对宫颈癌筛查准确性;并观察宫颈糜烂与ASCUS以上病变的关系。方法:4 119例经AutoCyteprep液基细胞学制片及2 713例巴氏涂片。细胞诊断采用TBS分级系统,阳性诊断包括意义不明的不典型鳞状细胞(ASCUS)以上病变。观察宫颈糜烂、光滑情况。结果:AutoCyteprep液基细胞学检出:ASCUS 7.38%(30 4 / 4 119)、LSIL 1.6 9%(70 / 4 119)、HSIL 0 .97%(40 / 4 119)、鳞状细胞癌(SCC) 0 .0 4 %(2 / 4 119) ,活检结果SCC 0 .12 %(5 / 4 119)。巴氏涂片检出:ASCUS 3.90 %(10 6 / 2 713)、LSIL1.0 3%(2 8/ 2 713) ,HSIL 0 .2 5 %(7/ 2 713) ,活检结果SCC 0 .0 4 %(1/ 2 713)。上述结果显示AutoCyteprep液基细胞薄片阳性率比巴氏涂片高:ASCUS提高了89.2 %(P <0 .0 1)、LSIL提高了6 4 .1%(P <0 .0 5 )、HSIL提高了2 88%(P <0 .0 1) ,活检证实5例SCC ,癌发现提高了2 0 0 %(P <0 .0 1)。宫颈糜烂/ASCS :液基组5 2 .6 0 %/ 10 .5 3%,常规组39.4 4 %/ 19.2 4 %。结论:AutoCyteprep液基细胞学(LCT)在检出LSIL、HSIL病变阳性率比传统巴氏涂片是有明显优势,宫颈糜烂与ASCUS以上病变发病率不成比例,在普查中应重视细胞学检查,尤应注意,宫颈呈光滑但宫颈上皮细胞间变,以免漏诊。Objective:To evaluate the efficacy of liquid-based (LB) technologies (Auto cyte prep Test, LCT) for cervical carcinoma screening. Methods:4119 LCT were compared to 2713 conventional Pap smears collected and performed diagnostic TBS. Results:The following results for the intraepithelial lesions: LSIL (1.69% LCT, 1.03% conventional), HISL (0.97% LCT, 0.25% conventional),SCC(0.04%LCT). ASCUS was diagnosed in 7.38% of LCT and 3.9% of conventional. LCT/conventional ratio was ASCUS 89.2%(P<0.01), LSIL 64.1%(P<0.05), HSIL 288%(P<0.01). Biopsy were observed in LCT and conventional. Among these cases, squamous cell carcinomas was (5 LCT, 1 conventional). Incidence of cervical erosion and ASCS↑ was 52.60%/10.53% of LCT and 39.44%/19.24% of conventional Pap respectively, cervical erosion is not definitely in proportion to cervical cell atypical hyperplasia, whereas cervix precancerous lesion is colosely related to cervical cancer. Conclusion:LCT for cervical cytology have been developed in order to decrease the number of false-negative Papanicolaou smear results. therefore,in mass sureies, more attention should be paid to cytological exmination, especially to those smooth cervixes with cell atypical hyperplasia in order to avoid missed diagnosis.

关 键 词：宫颈肿瘤 液基细胞学 筛查 宫颈糜烂 

分 类 号：R446.69[医药卫生—诊断学] R737.33[医药卫生—临床医学]